Problems and solutions in IGRT for cervical cancer

Ríos, I. García; Vásquez, Ilse; Cuervo, E.; Garzón, Orozco; Burbano, Johnny

doi:10.1016/j.rpor.2018.05.002

Cited by 19 publications

(18 citation statements)

References 48 publications

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“…8 This reduction in treatment time can be utilised for proper image verification which can minimize the treatment uncertainties and reduce the risks of target miss which is considered as the biggest problem with IMRT. 24…”

Section: Discussionmentioning

confidence: 99%

Dosimetric comparison of organs at risk with three-dimensional conformal radiation, intensity-modulated radiation and volumetric-modulated arc therapy in cervical cancer: a cross sectional study

et al. 2021

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Three-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) are the three main radiotherapy treatment techniques for cervical cancer. Whether either technique significantly reduces the radiation exposure to organs at risk remains unclear. We dosimetrically compared the irradiated volumes of bone marrow, bladder and rectum in cervical cancer patients using 3DCRT, IMRT and VMAT techniques in those patients with FIGO stage IIIB cervical cancer, receiving chemo irradiation at our institute. A total of 10 patients were dosimetrically compared. Significant reduction in V10, V20, V30, V40, V50 Gy of bone marrow was observed with IMRT and VMAT when compared to 3DCRT. Similar results were seen with V20, V30, V40, V50 Gy of bladder, and V40, V50 Gy of rectum. While comparing IMRT and VMAT, statistically significant dose reduction was noted in V20 Gy of bone marrow and V20 and V30 Gy of bladder with VMAT. When compared with 3DCRT the use of IMRT and/or VMAT reduced the radiation exposure to bone marrow, bladder, and rectum volumes at various radiation dose levels. VMAT can further reduce the radiation exposure to bone marrow and bladder when compared with IMRT. Thus, we propose the use of VMAT in cervical cancer to reduce the OAR toxicities.

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Section: Discussionmentioning

confidence: 99%

Dosimetric comparison of organs at risk with three-dimensional conformal radiation, intensity-modulated radiation and volumetric-modulated arc therapy in cervical cancer: a cross sectional study

et al. 2021

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“…It is the main imaging method for determining the extent of cervical cancer infiltration and staging. It is also the main method recommended for brachytherapy in targeted delineation of cervical cancer . If the positions determined by US are similar to those determined by MRI, it can be considered that US can determine the actual positions of implantation needles.…”

Section: Discussionmentioning

confidence: 99%

“…Advanced cervical cancer is treated with chemoradiation therapy, and brachytherapy in radiotherapy occupies an important position because of its unique dosimetric advantage . However, in the advanced stages (IIB and above, especially stage IIIB), cervical cancer is often accompanied by parametrial infiltration, and it is necessary to increase the radiation dose to these regions.…”

mentioning

confidence: 99%

Clinical Application of Ultrasound Guidance for Parametrial Treatment of Advanced Cervical Cancer

Lin

Cheng

Shi

et al. 2019

J of Ultrasound Medicine

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Objectives-To evaluate the accuracy of ultrasound (US) in determining the positions of parametrial implants by comparing US with magnetic resonance imaging (MRI) for advanced cervical cancer.Methods-Patients undergoing brachytherapy with parametrial implantation for cervical cancer from February 2017 to February 2019 were involved in the study. The transverse section of the cervix (surface S 1 ) and the transverse section 1 cm above the external cervix (surface S 2 ) were selected from MRI and US images as the observation planes. In the MRI observation plane, the distances between the uterine titanium needles and the uterine tube/implanter were set as M 1 to M 4 ; in the US observation plane, the distances between the uterine titanium needles and the uterine tube/implanter were set as D 1 to D 4 . The differences and consistency in M and D of each group were then compared.Results-There were no significant differences between M and D in each group (P = .058; P = .821; P = .870; and P = .936, respectively). The intraclass correlation coefficients of M and D in each group were 0.970, 0.968, 0.952, and 0.956. A regression analysis showed that the relationships between M and D in each group were as follows: M 1 = 0.9449D 1 + 0.1812; M 2 = 0.9463D 2 + 0.0965; M 3 = 0.9176D 3 + 0.1233; and M 4 = 0.9253D 4 + 0.1224.Conclusions-In parametrial brachytherapy for cervical cancer, US can accurately determine the positions of parametrial implantation needles, which is already applicable on MRI, and can provide assistance in parametrial brachytherapy for advanced cervical cancer.

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“…A further 5e7 mm margin is then applied to the ITV to account for set-up error, with the advantage that the internal margin is patient specific. Accurate online image guidance is required to ensure that the CTV is moving as predicted [32,33], and the subsequent use of CBCT softtissue matching in image-guided radiotherapy has become established [34]. In many centres, the CBCT review was initially carried out by a physician to identify any systematic errors, but over time, and with training, therapy radiographers (RTTs) are able to carry out online soft-tissue matching and identify any possible geographical or near misses [35].…”

Section: Adaptive Strategies For Organ Motion Management During External Beam Radiotherapymentioning

confidence: 99%

Adaptive Radiotherapy in the Management of Cervical Cancer: Review of Strategies and Clinical Implementation

et al. 2021

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Problems and solutions in IGRT for cervical cancer

Cited by 19 publications

References 48 publications

Dosimetric comparison of organs at risk with three-dimensional conformal radiation, intensity-modulated radiation and volumetric-modulated arc therapy in cervical cancer: a cross sectional study

Dosimetric comparison of organs at risk with three-dimensional conformal radiation, intensity-modulated radiation and volumetric-modulated arc therapy in cervical cancer: a cross sectional study

Clinical Application of Ultrasound Guidance for Parametrial Treatment of Advanced Cervical Cancer

Adaptive Radiotherapy in the Management of Cervical Cancer: Review of Strategies and Clinical Implementation

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